Why ProDeMa®?

In the area of health care and social services, i.e. when in contact with patients, occupants or clients, the probability of experiencing violent behavior and tense situations is significantly increased. Among others we can identify the following causes:

• Disease and poverty create strong emotional distress (e.g. fear, loss of autonomy, pain, loss of self-esteem, grief etc.)
• Patients and clients are frequently subject to frustrating situations (e.g. long periods of waiting, diagnostic findings, loss of functionality and of personal skills, restrictions in the satisfaction of personal needs etc.)
• Partially a lack of understanding of the necessity of therapeutical measures or rules can be found (e.g. children, patients with handicaps or dementia or other mental disorders). Assistance, care or treatment may in that case be perceived as violence.
• For patients and personnel alike there are numerous stress factors and situations of excessive demands.
• Difficulties in communication or in building a relationship between client and personnel can lead to violent behavior.
• Pressure to meet expectations for patients/clients (e.g. compliance, autonomy etc.) and for personnel (e.g. always to present, friendly, and on time) is very high.

Consequently, there is a special necessity to look into the origins of violence and aggressive behaviour in systems and institutions of social welfare and health care and to study the possibilities of de-escalation.

Of course, you will find different requirements in different institutions concerning de-escalation management according to their distinctions in client structure. But professional practices in dealing with violence and aggressive behaviour must be the policy of every institution. If aggressive behaviour can originate –  even partially –  in either the ailment of the patient or in institutional structures, the patient has a natural right to be confronted with skilled and trained personnel, that can cope with his state of tension or violent behaviour in a professional manner.

Also, to minimize violence and the optimal handling of violent patients is an important criterion of certification in modern quality management of institutions (see KTQ manual 2009 by DKVG)

In addition, employers are obligated to guarantee a safe environment for their employees. More and more often workers in health care and social services are - sometimes gravely - injured physically and mentally due to sustained attacks by patients. Statistics show that depending on the institution between 30 and 50 percent of all occupational accidents are due to assaults by patients. Hence schooling for employees to handle violent behaviour of patients is part of accident prevention and safety in the workplace.